In a case-control study involving 1,336 infants born in Norway during a 7-year period, women who had fillings placed in the first or second month of pregnancy had roughly quadrupled odds of giving birth to an infant with cleft palate. The odds were even higher among women who had fillings placed during multiple months of the first trimester.

Placement of fillings during these periods was rare, and the study had other limitations, cautioned lead investigator Lisa A. DeRoo, Ph.D. Still, the findings raise the possibility that fetal exposure to mercury from maternal fillings during a critical period in orofacial development may increase the risk of cleft palate. "Since this is the first study we know of that has examined this, it is probably a little premature to answer some of the questions [about the mechanism]," she commented. "But we do think it warrants further study."

The American Dental Association declined to comment. Two-thirds of infants with facial clefts do not have any family history of the condition, and research has implicated a variety of environmental exposures, according to Dr. DeRoo, an epidemiologist with the National Institute of Environmental Health Sciences in Research Triangle Park, N.C. Amalgam fillings continuously give off small amounts of vaporized elemental mercury, which is inhaled and can cross the placenta and accumulate in the fetus, she explained. "Among mothers who have amalgam fillings, the number of fillings they have correlates with mercury measured in cord blood and breast milk." Using data from the Norway Facial Clefts Study (NCL), a population-based case-control study, the investigators assessed associations between maternal amalgam fillings and two categories of facial clefts that appear to have different etiologies: cleft lip with or without cleft palate, and isolated cleft palate.

The study involved 573 infants with facial clefts (66% with cleft lip with or without cleft palate, and 34% with isolated cleft palate) identified shortly after birth and 763 randomly selected control infants, all born between 1996 and 2001.

Within 4 months after birth, the infants' mothers completed questionnaires asking if they had amalgam fillings placed during the first trimester of pregnancy and, if so, in which month(s). This exposure window was chosen in light of what is known about the timing of both fetal development and mercury release after filling placement, Dr. DeRoo said.

Specifically, the fetal lip and palate close between weeks 5 and 10 of pregnancy, she explained. And "new placement of fillings leads to a transient higher mercury concentration that peaks at about eight- to ninefold normal levels about 1-2 weeks after the filling has been placed." Study results showed that very few of the women overall, merely 44 (3%), had fillings placed during the first trimester of pregnancy, Dr. DeRoo reported. About 27 had fillings placed in the first or second month, and 19 did so in the third month. Just 6 had fillings placed in multiple months of the first trimester, used as a measure of higher level of exposure.

In adjusted analyses, women who had fillings placed in the first or second month of pregnancy had a significant near quadrupling of the odds of giving birth to an infant with isolated cleft palate relative to their counterparts who did not have any fillings placed during those months (odds ratio, 3.6).

In addition, women who had fillings placed in multiple months of the first trimester had a significant, even greater increase in the likelihood of this outcome relative to their peers who did not have fillings placed in any of those months (OR, 17), albeit with very wide confidence intervals because of the small number with this much exposure.

"I want to point out, though, that all five women who reported having placements in both months 1 and 2 had infants with cleft palate," Dr. DeRoo noted. "Four of them had infants with cleft palate only, and one of them had an infant with cleft lip with cleft palate."

Placement of fillings in month 3 was not associated with an increased risk of isolated cleft palate. And placement of fillings during any of the intervals studied was not associated with a significantly elevated risk of cleft lip with or without cleft palate.

Recall bias was a potential limitation, acknowledged Dr. DeRoo. "However, we did see increased risk for only one of the cleft groups and for a specific time period," she noted. "We might expect, if recall bias was important here, you'd see it sort of broadly across all of these categories."

Lack of information on the number of fillings women had before or during pregnancy, and on removal of fillings--which also leads to a transient increase in mercury exposure--was also a shortcoming, according to Dr. DeRoo. Mark Richardson PhD discusses his study Inhalation of Mercury-Contaminated Particulate Matter by Dentists: An Overlooked Occupational Risk While lead researcher Lisa DeRoon describes the mercury exposure during placement as "transient", she fails to mention the context of that exposure which is enormous. The amount of mercury exposure during placement of a freshly made mercury amalgam filling exceed all occupational safety levels for mercury vapor. OSHA's Permissible Exposure Limit is 100 micrograms per meter of air.

A study published in the Journal of Human and Ecological Risk Assessment examined the amount of mercury contaminated particulate matter dentists are exposed to from the removal of amalgam fillings. This respirable particulate matter represents the vast majority of daily Hg exposure in practicing dentists, amounting to thousands of times over the safety limit as set by OSHA.

When the exposures in this study are added up, one gets the following levels. Vapour inhaled during 4 removals (approx 40 minutes total) = 0.067 mg Vapour inhaled during rest of time in office = 0.05 mg/Hg

When we asked Mark Richardson..."would patients be equally exposed", here was his response...

Not exactly. Although any given patient would have the same particulate exposure during a removal, and exposure to the same vapour concentration in the breathing zone during the removal, the patient would not be exposed to the particulate of 4 removals per day (average used in paper) nor would the patient be exposed to the Hg vapour in the office air throughout the remainder of the working day (as assumed for the dentist). Finally, the patient would not be exposed day in and day out to the particulate. In very approximate terms, the patient having a single removal would be exposed to approx 1/4th of the average daily exposure estimated for a dentist. However, the patient exposure would be considered ‘acute’ (single ‘dose’ or very short term duration) rather than chronic. Therefore the determination of risk would be very different, and would be considered much less serious than an equivalent exposure that continues daily over years.

RELATED ARTICLE: VITALS Major Finding: Women's odds of giving birth to an infant with isolated cleft palate were increased about fourfold if they had fillings placed in the first or second month of pregnancy and 17-fold if they had fillings placed in multiple months during the first trimester. Data Source: Population-based case-control study involving 573 infants with facial clefts and 763 randomly selected control infants born between 1996 and 2001.

Disclosures: Dr. DeRoo reported that she had no relevant conflicts of interest. Originally published in OB/GYN News / Oct, 2010 by Susan London THIS INFORMATION WAS PRESENTED TO THE FDA IN 2010, BY JIM LOVE OF THE INTERNATIONAL ACADEMY OF ORAL MEDICINE AND TOXICOLOGY ( www.iaomt.org ). Article published Dec 16, 2002 - LA Times

Dentists to post new warning signs

The California Dental Association and an environmental group were expected to sign an agreement in San Francisco Superior Court Monday requiring dentists to post new warning signs in their offices. The signs, alerting patients that they may be exposed to mercury and cancer-causing chemicals, will be in dentists' offices statewide by early 2003.

As You Sow, a San Francisco environmental group, brought the lawsuit against the California Dental Association under Proposition 65, an initiative that requires businesses and employers to post warnings if their activities might expose customers or employees to substances that are known to harm health.

The settlement calls for all 18,000 members of the association to post signs saying that amalgam contains mercury, a metal that is known "to cause birth defects or other reproductive harm," said Shawn Khorrami, the attorney representing As You Sow. It will also advise customers that chloroform and methylene chloride - sealants used in root canals, fillings, bridges and crown treatments - are chemicals known to cause cancer.

The dental association still believes dental amalgams are safe, said group spokeswoman Lori Reed, and relies on federal health agencies for guidance. The Food and Drug Administration states the mercury in dental amalgams poses no health risk. Jim Dufour, the dental association's attorney, said the suit was resolved amicably. "Proposition 65 is not about a health risk. It's a consumers' rights law." Both New Hampshire and Maine have laws requiring consumer notification and education about the dangers of mercury in dental amalgams. Similar legislation is being discussed in Massachusetts, according to Michael Bender of the Mercury Project.

Mercury Dental Fillings Said Safe The Associated Press

WASHINGTON (AP) - The government still considers mercury-containing dental fillings safe and is awaiting results from two major studies of children's cavities that may settle lingering public doubts. Amalgam fillings, sometimes called silver fillings, are made of a mixture of mercury and other metals, and have been used by dentists for over 100 years.

Critics argue that mercury may leach from those fillings and cause brain disorders such as autism. Some families of autistic children have sued dentists, and legislation introduced in Congress last spring seeks to ban the fillings by 2007. Repeated reviews from federal health officials have found no proof the fillings are dangerous, officials from the Food and Drug Administration and National Institutes of Health told a congressional committee Thursday.

More evidence may come in 2006, when two major studies comparing the health of more than 1,000 children given either amalgam fillings or a mercury-free kind are to end, said NIH dental chief Lawrence Tabak. The studies, funded by NIH in 1996, are measuring levels of mercury in the children's bodies, and giving them IQ tests and other brain assessments. Special oversight boards review the children's medical records every year, and ``to date there have been no harmful untoward effects attributable to amalgam noted in either trial,'' Tabak told the House Government Reform Committee.

Mercury is a toxic metal that can be absorbed from different sources, such by eating fish from polluted waters. Indeed, the FDA warns pregnant women and young children to avoid certain fish species that contain high mercury levels. Why, wondered the committee chairman, Rep. Dan Burton, R-Ind., is the FDA is worried about one type of mercury and not another.

``Mercury is mercury,'' said Burton, a comment echoed by other mercury critics at the hearing. ``Shouldn't we exercise abundance of caution and hasten the use of those (mercury-free) alternatives?''

The American Dental Association argued that the mercury in fillings is a different form of the metal that is safe to use, and that amalgam fillings are both cheaper than other types and the best option for certain cavities. By: CINDY VAN DONSELAAR 10/11/2002

Joyce Van Haaften believes a radio show saved her life. The show mentioned a link between silver fillings containing mercury and serious illnesses. Someone said the fillings could cause mercury poisoning. "I was on a downhill slide," says Van Haaften. "My health was deteriorating fast. My head pounded all the time, the pressure so intense it even hurt to rest my head on a pillow. I had partial numbness in my extremities, memory loss, and towards the end tremors." For three years Van Haaften battled to return to normalcy. Before her illness she enjoyed gardening. She tried everything she could think of to be able to enjoy gardening again. As her health continued to fail, she couldnít get out of a chair without assistance. At one point she borrowed a walker. Her husband considered resigning from his position as Marion County Sheriff. Then, she recalled the radio show. Van Haaften began researching the subject, including looking in the mirror. What she saw convinced her that she was suffering from mercury poisoning. "The gray discoloring on my gums was irrefutable evidence of mercury poisoning," says Van Haaften. Debate over amalgams The American Dental Association (ADA) is fighting a debate over the safety of silver fillings, also called amalgams. The ADA says amalgams are safe and dispute claims that people, like Van Haaften, become ill from them, although the organization does admit mercury vapor is released into the body during the chewing process. Researchers first discovered vapor escapes from amalgams some 20 years ago. However, the ADA maintains the amount of mercury vapor released into the body is a minute amount and no scientific evidence exists showing exposure is harmful. In order to determine the health risk posed by mercury fillings, the Food and Drug Administration (FDA) launched a two-year study on amalgams in 1991. It's findings released in 1993 and reaffirmed in 1995 and 1997ã endorsed the continued use of dental amalgams. According to the study, available data is "not sufficient to indicate that health hazards can be identified in non-occupationally exposed persons." The FDA further noted research showed results that human exposure from mercury amalgams ranged between 1.24 to 29 micrograms a day. Other organizations, such as the U.S. Department of Health and Human Services have found mercury amalgams release three to 17 micrograms of mercury per day. The World Health Organization (WHO) reported it would require about 500 amalgam surfaces to reach the point set by WHO where particularly sensitive individuals might develop subtle toxic effects. "In all candor, the dental profession believes they [amalgams] are safe," says Executive Director of the Iowa Dental Association, Larry Carl. "The FDA, the U.S Public Health Sercive, and the National Institute of Health have all studied amalgams and say they are safe." At the same time, the ADA says that mercury in fillings is chemically bound that it cannot be seperated by physical means, such as chewing and when mixed with other chemicals it becomoes biologically inactive. Van Haaften says they are contridicting themselves. "How can they say it is chemically bound when they admit vapor is released?" she questions . "It just doesnt make sense." Van Haaften also points to other research that indicates mercury amalgams can be toxic. She points to an article that appeared in the Journal of the ADA summarizing research findings of the U.S. Public Health Service on the benefits and risks of amalgams. The article said evidence exists that mercury levels spike in body fluids during placement or removal of amalgams. Van Haaften says the same statement can also be found on the material safety data sheet put out by a manufacturer of mercury amalgams. The safety sheet also warns against using amalgams in pregnant women and children under the age of six. The manufacturer also recommends the number of amalgams used for one patient should be kept at a minimum. "The information is out there, you just have to look," says Van Haaften. "You only need to know how to read to see that amalgams present a safety risk." Research on amalgams is conflicting and so far has not convinced Pella dentist, Dr, David Barnes that amalgams can cause illnesses. "Until studies unequivocally show a link between sliver fillings and illnesses, I will continue to use mercury fillings when it is the best option for my patient," says Barnes. However, Barnes notes that although mercury amalgams have a good track record in the dental profession, widespread use of the product is a thing of the past. According to Barnes, mercury amalgams are no longer the first choice of restorative materials. He estimates he uses silver fillings one half to one percent of the time to repair decaying teeth. "In my opinion, there are better materials out there to use," he says. "The last six to seven years better materials with better properties have become available that you get out of amalgams." He also notes the trend in dentistry is towards more aesthetic materials. The safety of mercury amalgams is so controversial it has split the dental profession into opposing camps those who still use mercury amalgams and those who do not. When Van Haaften decided to have her fillings removed, she traveled to an amalgam-free dentist out of town. Shortly after taking out her fillings, her dentist, Larry Hanus lost his dental license. Hanus accuses the ADA of taking his license away because of his stand on almalgams. The ADA contends that his amalgam-free stand has nothing to do with suspending his license. Rather, the organization says Hanuss was incapable of making dignoses. The ADA also issued a ruling that says member dentists cannot discuss removing fillings with their patients. According to the ADA, the ruling is for the protection of consumers. "What the advisory opinion is designed to do," says ADA General Counsel Peter Sfikas, "is prevent a dentist from telling someone who has a serious illness that by taking out the amalgam filling this person would be cured. Its really trying to prevent someone from preying on the fears of people who have serious medical conditions." Activists, including Van Haaften say the ruling - or gag rule - prevents dentists from speaking out on the issue, and puts dentists in the middle. "Dentists in this area have the best interest of their patients," said Van Haaften, "but are provided false information on the matter from the ADA. Patients are left to find out information on their own." Barnes, a member of the ADA, said he believes the ruling is in the best interest of of the public. "It protects vulnerable patients from those with no scruples." He does not recommend removal of amalgams to any of his patients, but does discuss different options with all his patients before procedures. Barnes also encourages patients to stay informed and ask questions. "Patients need to know what dentists are doing with their teeth," cautions Barnes. "They shouldn't be in the dark about dental care." What's next Today Van Haaften is healthy. She said once she had her silver fillings removed, her symptoms disappeared within months. She admits proving mercury poisoning is responsible for her health problems and those of others is difficult. It doesnt affect everyone and in many cases changes come on gradually. Van Haaften said she was at a higher risk for mercury poisioning because of the large number of fillings in her teeth. Van Haaften also blames the ADA for not being honest about the possibility of mercury poisoning. "Those who are supposed to protect us will not," she says. Van Haaften now works to ban the use of mercury amalgams in the United States. She is secretary of the Dental Amalgam Mercury Syndrome (DAMS) organization in Des Moines. Through her association with DAMS Van Haaften said she has witnessed people with serious illnesses return to normal life after removal of amalgams. She's also helped put together a book, "Solving the Puzzle of Mystery Syndromes" detailing the recovery of people with possible mercury poisioning. "I am convinced there is a health issued involved," says Van Haaften. Van Haaften has also testified before state hearings on the mercury issue. Although shes encountered set-backs and obstacles, Van Haaften is encouraged that someday the goal of banning mercury amalgams in the United States will be realized. Two members of Congress, Diane Watson (D- Calif.) and Dan Burton (R- Ind.) have introduced a bill that would ban the use of mercury amalgams in pregnant and nursing mothers, and children immediately upon passage of the bill. It also calls for banning using mercury for everyone by 2006. Not everyone thinks the legislation is a good idea, particularly the dental profession. Barnes, for one, isn't in favor of the proposed banning. Barnes said in some situations amalgams are the best option. "Amalgams are the best option when a patient needs an inexpensive filling or if we can't control conditions around the tooth," says Barnes. Van Haaften also realizes there is a lot to be done yet. But she feels so strongly about the issue she cannot stop working until the issue is solved. "If I wasn't so convinced this is so important, I wouldn't spend my time on it," she says. "I didn't ask for this. I would rather be working in my garden." Bill H.R. 4163- Hearing 11-16-2002 Notes of Carol Ward

Congressman Dan Burton: Intro There has been no test on Thimersol in vaccines since the 1920's. Three congressmen are here who are not in the House Reform Committee. He stated that amalgam fillings should be called Mercury fillings. Mercury vapor keeps on entering the body. Some people hold on to the mercury. There are toxicological factors. Mercury is not safe in food additives but it is safe in fillings (implied question)

Congresswoman Diane Watson- Intro to Bill 4163 Elected representatives are guardians of public health. In her work in California, she heard of all kinds of health problems (implied mercury-related). Mercury is being taken out of a lot of other products. She is concerned for minorities and the economically disadvantaged. She asked "Why take the risk?" (implied re: having amalgam fillings). In California a new dental board replaced the former board. Consumers have not been informed of the ingredients in amalgam. The public has a right to be informed. The ADA has a gag rule which keeps dental patients uninformed. It is now time for the ADA to stop their gag rule. Her bill includes for goals: to ban mercury amalgams for children under 18. To ban it for pregnant women and to have immediate dental disclosure, and to phase out mercury in amalgams by 1-1-2007. Mercury amalgams are a risk to lactating women. Children are most at risk. Dental amalgam is as big a risk as fish. Continuous vapor is released from amalgam fillings. Health Canada in 1996 advised against the use of amalgam fillings in pregnant women, people with braces, children, and those with kidney disease. Sweden, Germany, Austria, and Norway have announced plans to become mercury-free. The United Kingdom has said..that pregnant women should not get these fillings. Mercury is an environmental poison. NAACP members are against amalgams. They have endorsed her bill. This is a good beginning.

(Congresswoman Watson had to absent herself for other congressional business- she returned later in the day)

Testimonies: Mr. Butch Otter -Congressman (D-ID) Pro-ADA Dentists have used amalgam for 150 years. The U.S. Public Health Service, Center for Disease Control, the FDA have all conducted studies which concluded that all is well with amalgams. Amalgams are a cost-effective treatment. He hopes that we're not 'pulling the wrong tooth' today.

Congressman Charles Norwood- (dentist and Congressman)- R-Ga. He has practised dentistry for 25 years. He has always known that amalgam was safe. He thinks it has not affected him and feels that this misinformation is very dangerous in this hearing. He further stated that Mercury is not the SAME as amalgam. This will affect a large part of the population's dental care.

Congressman Michael Simpson, (dentist & Congressman) R-ID He is opposed to the Bill. He wants to put forth the science. If there were any credible evidence, he is certain that mercury would be removed immediately from any products. He said this is not a money issue. He says he has always been free to discuss anything with his patients. He made the point that amalgam and mercury are NOT the same.

Boyd Haley PhD- had several diagrams to illustrate his points. First, Autism in children. People have different reactions if they have a lot of toxic metals in their systems. Testerone levels and mercury interact. There is a gender risk (in males)for autism. Estrogen is protective. Cardiomyopathy: the heart tissue was found to be high in mercury. Tubulin is affected by mercury. Our brains do not have the protective mechanisms against mercury vapor. Alzheimer's brain: amalgam fillings decrease brain tissue's ability to build creatinin kinease. Mercury -classified as Class I (?)

Mark Richardson (Canada) Risk Assessment Specialist Excerpts from his testimony. The regulations concerning a Super- fund site do not permit as much mercury exposure to people living around it as the dental amalgam risk. Mercury crosses the placenta and contaminates breast milk. Reducing mercury in the environment would have a miniscule effect on people if amalgams were still in use.

Rich Fischer DDS -member of IAOMT One half of a gram of mercury will contaminate a 10 -acre lake. Between 14-75% of mercury in the environment is from dental offices. There is fetal exposure to mercury. At this point Rich was interrupted and questioned very sharply by one or other of the congressmen-dentists as to whether or not he recommended amalgam removal to his patients. He said he did not, per se, but in fact the patients requested it of him or had a doctor's recommendation.

The congressman then appeared to be mollified and called Fischer a good guy (don't quote me here)

Mackert (DDS) -Pro ADA He stated that amalgam is safe. There have been no control groups in the studies. He pointed to the Swedish adoption study in which twins who were raised apart or together were compared. There was no indication of amalgam damage. In 1988 4,077 patients were examined. There were no health difficulties in patients who had amalgam fillings as opposed to those who did not have them. Mercury in combination with other metals makes amalgam safe. All other agencies have reached the same conclusion- the MS Society, the CDC, World Health Organization,etc. Amalgam is safe for squirmy 3 year olds and the disabled because it is quick to install. Gregory Stout DDS (African American) President of the National Dental Association

Amalgam is good for big fillings. Unwarranted public anxiety will be caused (he implied that this will happen if the anti-amalgam view is publicized). Poor children will be a problem as they have a high rate of dental disease. Michael Bender - NEWMOA - Environmental effects of dental mercury. 8% of pregnant women have risky mercury blood levels. The United States are the largest polluters re: water. Approximately 70-100 million amalgams are placed per year. Crematoriums create an enormous release of mercury. Amalgam separators are needed in dental clinics and offices. In Toronto, Canada (through use of separators?) the mercury in sludge was reduced by 50-60%.

QUESTIONS;

Dr. Mackert- he said that amalgam swallowed from fillings amounts to only 1 mcgr.per day. He claimed that mercury vapor is emitted but only 1-3 mcgr. a day. Clarkson wrote the publication "Three Modern Faces of Mercury". The brain gets only 7% of what has been absorbed and it is rapidly excreted in 21 days (my notes are not totally clear here) Dr.Haley- There is a synergistic effect of other heavy metals on mercury in the body.

Dr.Mackert- the ADA always encourages patients to ask any questions they want.

Congressman Norwood (DDS) spoke to this effect "We are not talking about Mercury when we talk about amalgam". He went on to say that Medicare, state by state, varies in its coverage of non-amalgam fillings.

Dr.Haley may have been the one who stated that there has been a 40- fold increase in the incidence of Autism in recent years. Amalgam releases 43 mcgrs. per centimeter per day.(I wish I could remember the context but at one point Dr.Haley said to one of the pro-ADA panelists that he was just plain wrong)

Comments by Representative Dan Burton: To Dr.Mackert, he made this statement. He would like to have l00 American-made amalgams to be studied in various labs to see what percentage of mercury vapor is released. He also said at some point that he has had some of his amalgams replaced and is planning to have the rest done (wording would have to be checked)

Dr.David Fiegal-FDA When questioned by Rep. Burton, he stated that the FDA only labels products, it doesn't practise medicine.

Congressman Burton: He requested that the FDA place a card in each dental office stating that each amalgam filling contains up to 50% mercury.

Dr.Fiegal answered: The FDA cannot test the way Representative Burton would like but the Public Health Dept. can. Dr.Fiegal agreed to take care of this.

Congresswoman Diane Watson: She asked Dr. Fiegal- "Is Mercury Toxic?" He replied that in some cases it was but it depends on the amount. She asked why the FDA does not tell people about the risk factors in amalgam. He said that dental patients should know the risks of composites as well. Congresswoman Watson would like the FDA to educate the public. She is appalled that the FDA does not want to answer her questions directly. Why couldn't the FDA make long -term studies of the effects of Mercury? This is what her bill does (my notes are not clear here). She cannot understand why mercury amalgams weren't classified. Her bill will put in the required study (mentioned by Rep. Burton) with the money to fund it. She stated further with great emphasis that there is nothing more important to her than the health of the American people.

(Note: Dr.Haley was grilled somewhat harshly on his educational background by Congressman Norwood. Norwood, after hearing his educational background referred to him as a 'smart boy'. )

Post Script- conversation with Ann Ferreira 11-17-2002 I apparently left out one panelist - a Mr. Adak (?) this may have happend during a break that I took. The House Committee videotaped and audiotaped the proceedings. C-span was not there. Three or four young journalists were taking notes. the panelist I did not hear was Lawrence Tabak, NIH-Dental Chief.

Summary of Government Reform Committee on Mercury Amalgam Dental fillings from CZ:

Hi,

I just got back from the amalgam hearings in Washington and thought I'd make a quick summary if you don't mind. There was good news and bad news. Bad news, congressional turnout was very low in fact only Norton Watson Burton Gilmer and three guest dentist congressman showed. Good news, the questioning by Watson, Burton and Gilmer was spectacular and put the ADA and FDA on the extreme defensive. Burton was furious with the FDA on the amalgam issue, yes, he gets it, and Watson put the ADA and FDA to shame. At the conclusion of the hearings Burton left little doubt that he would hold more hearings on the amalgam issue and give the issue his close attention through the year. Watson and Burton also made it clear that they expect the FDA to begin at the least some kind of formal testing of lone amalgams outside the mouth for vapor release and Burton hinted that he may ask the FDA to convene a special scientific panel for more full investigation of amalgam effects which could possibly include Boyd Haley.

On the first panel Mackert, materials specialist was a key witness for the ADA and lied with abandon. He repeatedly asserted that amalgams do not release large amount of mercury, stated for example that coffee does not increase mercury release and stated that studies had been done on thousands of people showing the safety of amalgam. However, he wasn't fooling anybody. As he testimony continued he began to elicit audible chuckles from the room and Burton skeptically cross-examined his statements and finally under cross examination Boyd Haley flatly stated that when it came to levels of mercury release from amalgam Mackert was lying.

On the second panel Fiegel was the representative from FDA devices and defended amalgams to the hilt stating that he believed amalgams would be approved if subjected to that process today from scratch. When asked why the EPA had found amalgams to be unsafe by Burton he compared mercury with radiation from the T.V. or discarded needles in terms of classification for potential but not necessary danger. A visibly reddening Burton then said, "Come' on man. Are you comparing T.V. radiation to mercury?" and subjected Fiegel to a litany of embarrassing questions the FDA answers to which were mind numbing. For example Fiegel stated that amalgams could not be tested many times because the formulation was proprietary and the devices division does not "do" testing. Burton was perceptive and was able to ask simple piercing questions which showed how ludicrous Fiegels position was and the room joined in sometimes showing their approval.

Finally near the conclusion of the hearings Watson lit into Fiegel calling the FDA,s position a violation of public trust and stating that if he didn't know what to do about amalgams then she would add an amendment to her bill to tell him what to do. Watson's questioning was heartfelt, she was visibly disturbed by Fiegels lack of concern about mercury and its affects onchildren and adults and her questioning was too the point, lucid and left one with any empty feeling in the pit of the stomach when the FDA's response left no doubt about their lack of concern for the health of the public.

Boyd Haley's testimony was good but brief and limited to the neurological affects of mercury and biochemical synergistic affects. Other panelists gave strong anti-amalgam testimony and let it be known that other countries were moving to restrict amalgam and that the US was out of step with current research.

An update on the Government Reform Committee on Mercury Amalgam Dental fillings from Christy

Hey Sandy! It is intense here, it is amazing, it is incredible in every way. The hearings were far from what was represented in your attachment. It was heated. There were mis representations coming from the Pro amalgam side at every angle. It was clear that the committee members were incensed by the obvious attempts not to answer straight forward questions. At one point, Burton attempted to get the FDA to farm out studies that would be sourced from the ADA, FDA, UofK, etc of different commonly used Hg amalgam mixtures to mutually agreeable lab tests at places like Harvard, Yale, etc and see if they come up with Haley's results of how much vapor comes off an Hg filling. It took at least 20 minutes to get the FDA and ADA folks to agreed to it, but Burton did it.

Congressman Watson took this a step further. At one point Watson felt it necessary to tell both Dr. Tabak from the NIDCR, and Dr. Feigal, Director of the the Center for Devices and Radiological Health,FDA that the questions she was asking were "yes" and "no" questions and clarified that for the next three or four questions in case they forgot. She announced she is going to amend the bill to include this mutual study with some funding. I learned at this meeting the FDA does not do any of their own testing of products they release for public consumption. They accept whatever the MFG gives them as long as they follow their parameters. The FDA approves 40 products a day without doing a single test on any of them. Congressman

Gilman responded to this by stating, "Isn't this like locking the fox up in the hen house?" Burton said, "Come on, you mean to tell me you don't do any testing but you can raid a group that basically has supplements?" There was a lot more but those are some highlights I thought everyone would enjoy. Most everyone thought this was the beginning of the end and there will be, still, lots more work. One thing is certain. Watson and Burton, CLEARLY, know what is going on...They both were quite impressive with their knowledge of the subject and how they both handled the situation. I am exhausted but could not ignore your request before I fall over. I'm sure you will hear more soon!

1819: Invention of silver/mercury amalgam by the English chemist, Bell. 1826: First use of dental amalgam in England and France. 1830: Amalgam fillings first used in the U.S. 1840: Organized dentistry denounced the use of amalgam as a poor filling material, especially due to concerns about mercury poisoning. - American Society of Dental Surgeons formed. Members were required to sign a pledge promising not to use mercury fillings. 1859:American Dental Association was formed. The ADA supported the use of silver amalgam then as the filling material of choice, as it still does today. 1926: The German chemist, Dr. Alfred Stock researched mercury poisoning and identified through his research that silver amalgam fillings in the mouth were a source of mercury vapor. 1957: Dr. Karl 0. Frykholm's studies in Sweden concluded that when saliva covered the amalgam filling, mercury is no longer released. 1976: The Federal Drug Administration pronounced acceptance of amalgam fillings and "grandfathered" their approval under the G.R.A.S. (generally recognized as safe) category, due to its long term usage. 1979: Research began appearing in the literature documenting that mercury vapor was constantly being released from amalgam fillings, especially when the flllings were stimulated by chewing, brushing, or heat exposure. 1984: Human autopsy studies were published which demonstrated that the amount of mercury found in brain and kidney tissue was directly related to the amount of mercury amalgam fillings in the teeth. - Significant research at the University of Calgary School of Medicine demonstrated that mercury from dental amalgam fillings could be found in the blood and tissues of pregnant mothers and their babies within a few days. 1990: The first controlled research on the effects of dental amalgam were published. The research cited significant effects of mercury amalgam on various tissues and organs in experiments with monkeys and sheep. The media became involved when the T.V. show "60 Minutes" aired a segment entitled, "Is There A Poison In Your Mouth?" 1991: Many D.A.M.S. (Dental Amalgam Mercury Syndrome) support groups became more active in consumer awareness of the mercury amalgam issue. - The first products liability suit against a manufacturer of amalgam in connection with mercury poisoning was filed in Tennesse. Consumer activist groups along with concerned legislatures began to introduce "informed consent" legislation, whereby a dentist would be required to inform the patient of the contents of the amalgam filling and the potential harmful effects of the mercury component (Such legislation was voted down in committee in New Mexico after being unanimously passed the previous week by the same committee).

Sweden declared that amalgam will be banned. (The majority of dentists are voluntarily not using amalgams in pregnant women). A law suit was filed (by approximately 100 dentists) against the American Dental Association for fraud and breech of contract regarding the amalgam issue.

The F.D.A. "reviewed" amalgam as a filling material and declared that current evidence was insufficient to condemn amalgam. They did recommend, however, further studies be done. May: The Illinois House of Representatives passed a Right-to-Know, Informed Consent Resolution. This resolution directed the Illinois Department of Public Health to examine the existing research and literature and to make a report to the Illinois General Assembly of its findings as well as recommendations as to how patients should be informed of these findings. The resultant position paper reflected the ADA's position on amalgams as being safe.

A medical research team at the University of Kentucky established a probable relationship of mercury exposure from silver amalgam dental fillings to Alzheimer's disease and cardiovascular disease. University of Georgia microbiologists determined that mercury from fillings inhibits the effectiveness of antibiotics. World Health Organization reported that exposure to mercury from amalgams is higher than from fish, seafood, water and air. August: The National Institute of Health Technology Assessment Panel on Dental Materials issued a statement that amalgams are safe. October: The Washington Dental Disciplinary Board proposed dental ethics legislation that would have made it unethical and a punishable offense for dentists to replace "clinically serviceable" dental amalgam fillings for health purposes. The proposal did not pass. 1992: February: At the annual meeting of the Society of Toxicology, medical scientists presented five studies demonstrating adverse health effects of mercury exposure from amalgam fillings. The California State Senate passed an "informed consent" bill regarding the use of dental amalgam. The bill (SB934) must still be approved by the State Assembly and the Governor. The German Federal Department of Health banned the manufacture and sale of one specific brand of dental amalgam filling material.

A logical approach to the amalgam issue would be for the F.D.A. to reclassify amalgam to a Class III device. Such a classification would require the manufacturers to submit the results of safety and effectiveness research in order to continue its manufacture. In other words - to prove that amalgam is safe - the same request that the F.D.A. has made of silicone breast implant manufacturers.

The World Health Organization, O.S.H.A., N.I.O.S.H., etc, all agree that mercury's an environmental poison and have established specific occupational exposure limits. The Environment Protection Agency has declared amalgam removed from teeth to be a toxic waste. Even the American Dental Association warns that amalgam filling material is hazardous to dental office personnel, but is safe in patients' mouths.

The most puzzling thing about this 160 year old controversy is that it is still a controversy.

PRO-AMALGAM DENTISTS AND THE ADA ASSERT THAT:

MERCURY-FREE DENTISTS AND ANTI-MERCURY ACTIVISTS RESPOND: 1. Mercury in dental amalgams chemically binds with the alloy metals and results in an inert substance. The ADA also frequently claims that the components of amalgams are analogous to sodium and chlorine which are hazardous in their pure form but combined to form ordinary table salt.

1. An amalgam is a mixture and the properties of the components remain the same, i.e. a mercury atom remains a mercury atom and remains highly toxic, vaporizing and leaching out of the amalgam. Table salt is a compound, i.e. a new molecular structure which has different properties than the individual components . Guzzi, et al, The Lancet, 360:2081, Dec 21/28,2002; David M. Eide (Grant High School chemistry teacher), The Oregonian, Letters to the Editor, Dec. 30, 2000.

2. If mercury is emitted from amalgams, it is only in very minute amounts.

2. The average amalgam weighs 1 gram and is 50% mercury. As much as 50% of the mercury in an amalgam has been found to have vaporized after 5 years, and 80% after 20 years. Pleva J, "Dental mercury - a public health hazard", Rev Environ Health 10(1):1-27 (1994); Pleva J, Mercury from dental amalgams: exposure and effects, Int J Risk & Safety in Med, 1992, 3: 1-22.

An exacting study conducted in 1991 evaluated the amount of mercury emitted from a common amalgam in a test tube with 10 ml of water. This study showed that ³the over-all mean release of mercury was 43.5 mcg per cm2/day, and the amount remained fairly constant during the duration of the experiments (2 years).² This was without pressure, heat or galvanism as would have occurred if the amalgams were in a human mouth. Chew, CL, et al, Long-term dissolution of mercury from a non-mercury-releasing amalgam, Clinical Preventative Dentistry, 13(3):5-7, May-June (1991).

3. The small amounts of mercury emitted from amalgams are not bioavailable.

3. Mercury vapor from amalgam is the single largest source of systemic mercury intake for persons with amalgam fillings. Average daily exposure for mercury is 3-17 ug. per day; for fish is 3 ug per day; for air it is .04 ug per day; and, for water .05 ug per day. WHO Document 118, p.36, 1991; A 1998 study by NIDR concluded that amalgams were the primary source of mercury in the urine of military personnel. A. Kingman et al, National Institute of Dental Research, "Mercury concentrations in urine and blood associated with amalgam exposure in the U.S. military population", Dent Res, 1998, 77(3):461-71.

4. There is no credible scientific evidence supporting a link between silver fillings and systemic diseases or chronic illnesses.

4. Dr. Murray Vimy, Clinical Associate Professor, Faculty of Medicine, University of Calgary, prepared a document which sets out dental journal articles from 1957 to 1984 which very clearly show that mercury amalgams cause gingivitis and periodontal disease. This document can be downloaded from the website: http://www.testfoundation.org/vimyresponds.htm In turn, periodontal disease has been linked to cardiovascular disease and pre term, low birthweight babies. Greenwell H, et al, Emerging concepts in periodontal therapy, Drugs, 2002;62(18):2581-7.

The ³previous data² included a study in which the authors concluded that: ³We believe one Š[theory of the pathogenesis of Alzheimer¹s] could be mercury vapor to which the majority of individuals are continuously exposed [from dental amalgam]. By reducing levels of viable brain tubulin, mercury vapor could exacerbate the conditions related to the onset of symptoms identified with Alzheimer¹s.² Pendergrass, JC, et al, Mercury vapor inhalation inhibits binding of GTP to tubulin in rat brain: similarity to a molecular lesion in Alzheimer diseased brain, NeuroToxicology 18(2):315-324 (1997).

Mercury is a potent neurotoxin and many peer reviewed scientific studies have found evidence that amalgam fillings may play a major role in central nervous system diseases such as depression, schizophrenia, memory problems, ALS and Parkinsons¹s, www.home.earthlink.net/~berniew1/amalg6.html

There are 1000¹s of other studies showing adverse health effects from mercury in general, and amalgam in particular. www.altcorp.com, www.amalgam.org, www.bioprobe.com, www.iaomt.com www.home.earthlink.net/~bernie1/amalg6.html

5. If amalgam was bad for you, dentists would be the canary in the mine and, in fact, they have no more health problems than anyone else.

5. A CDSPI Report (supplies malpractice insurance to dentists) was published in the Journal of Canadian Dentists in 1994. It reports that suicide rates among dentists are double those of other professions; 20% of dentists at any given time are on long term disability due to mental or nervous conditions including depression, increased alcohol consumption, fatigue, insomnia, ulcers and heart problems.

6. No other country has banned the use of dental amalgam.6. Most other developed countries have issued limited bans, or mandated health warnings regarding the use of mercury amalgam including: Canada, Great Britain, France, Austria, Norway, Sweden, Switzerland, Japan, Australia and New Zealand. Swedish National Dept. of Health, Mercury Amalgam Review Panel, 1987; Heavy Metal Bulletin, Dec 2000, Vol 6, Issue 3.

A Swedish National Mercury Amalgam Review Panel and a similar Norwegian panel found that ³from a toxicological point of view, mercury is too toxic to use as a filling material.² Id.; Press Release, Swedish Council for Planning and Coordinating Research (FRN), Stockholm, 19 February, 1998; Norwegian Board of Health, Report 2652,http://www.helsetilsynet.no

7. A few people can be allergic to amalgam, but there are only 50-100 reported cases.

An important new study from the United Kingdom found that mercury can cause allergic and immunotoxic reactions, but there are no dose-response studies for immunologically sensitive individuals and, therefore, ³it has not been possible to set a level for mercury in blood or urine below which mercury related symptoms will not occur.² Kazantzis, G., Mercury exposure and early effects: an overview, Med Lav 2002 May-June;93(3):139-47.

8. The U.S. Public Health Service, including the National Institutes of Health, the Food and Drug Administration, the Centers for Disease Control and the World Health Organization have all concluded that amalgam is a safe and effective restorative material for dental fillings.

8. In 1993 the PHS Director, Dr. James O. Mason, in an introductory letter to the USPHS CCEHRP report states: ³Because the possibility of adverse health effects resulting from the use of dental amalgam cannot be fully discounted based on available scientific evidence, I am requesting the National Institutes of Health, the Centers for Disease Control and Prevention, and the Food and Drug Administration to undertake an expanded and targeted program of research, professional and consumer education and product regulation.²

That report, at page 3 states: ³In the absence of adequate human studies, the Subcommittee on Risk Assessment could not conclude with certainty whether or not the mercury in amalgam might pose a public health risk.² The USPHS, Agency for Toxic Substances and Disease Registry also has a publication entitled: Toxicological Profile for Mercury Update TP ­ 93-10 (1993) which specifically states that ³the continuous exposure to mercury from amalgam fillings is not without risk to patients.² At p. 25. The American Dental Association never acknowledges that there is a 1999 Update of the USPHS publication which clearly states that amalgam is the primary source of human body burden.

Two presenters at an NIH/NIDR Technology Assessment Conference in 1991 presented significant documentation of adverse effects of mercury amalgams. The Final Statement of this conference was written by W.D. McHugh and the Conference Editor was Joyce a. Reese; both are dentists. The Final Statement from that Conference is not a strong endorsement of the safety of mercury amalgams. It states: ³While the current evidence supports the concept that existing dental restorative materials are safe, it must be recognized that the supporting data are incomplete.² (Advances in Dental Research, Vol. 6, page 143, Sept. 1992.)

One of the presenters of the adverse effects of mercury amalgam wrote to protest the Final Statement. The NIH responded to him thus: ³The recognition of the paucity of data on the subject, especially with regard to mercury, was the reason for using the term ŒTechnology Assessment¹ rather than ŒConsensus Development.¹ Our guidelines for a Consensus Development Conference do require the statement to be data-based to the extent possible Š. In regard to the studies you presented being ignored, they were definitely considered and discussed at length, but not emphasized in the Final Statement.²

In response to public uproar after the airing of the CBS 60 Minutes segment called: ³Is there poison in your mouth?² the FDA held a Dental Products Panel Meeting on March 15, 1991. At page 208 of a transcript of that meeting, there is a list of Panel Recommendations. It includes: ³Without the addition of any statements that reflect that the Panel feels that there is any unsafety [sic] to the use of dental amalgam as a restorative material, I would ask the Panel, now, that the information under review today, if that information raises questions that warrant further research. I will poll the Panel for a yes or no vote.² All Panel members voted ³yes,² therefore all agreeing that questions about the safety of amalgams had arisen. The Panel made no declaration that amalgam was safe or harmless.

The latest FDA Consumer Update (December 31, 2002) informs consumers that Canada limits the use of mercury amalgam in pregnant women and it indicates that the FDA is reviewing the scientific studies related to the safety of mercury amalgam. While the FDA has up until now indicated that there was insufficient scientific proof that mercury amalgams cause adverse health effects, it has never declared mercury amalgam to be safe.

A World Health Organization (WHO) Scientific Panel in 1995 concluded that there is no safe level of mercury exposure. The Chairman of the panel, Lars Friberg stated that ³dental amalgam is not safe for everyone to use.² L.T.Friberg, "Status Quo and perspectives of amalgam and other dental materials", International symposium proceedings, G.Thieme Verlag Struttgart, 1995.

Additionally, the U.S. EPA found that mercury amalgam fillings which are removed from dental patients are hazardous waste and must be sealed airtight and disposed of as such. "Amalgam declared hazardous", Dentistry Today, February, 1989, p1.

Boyd Haley Ph.D. - Professor and Chair of the Department of Chemistry - University of Kentucky states that the "amount, (of mercury in dental fillings), is colossal using any standard. I am aware of no other situation today where grams of mercury are implanted in any human being." Dr. Haley went on to present definitive scientific evidence of the connection of mercury exposure to a plethora of illnesses. This included his most recent research on the birth hair of newborns showing the relationship of mercury exposure in amalgam fillings in a mother to her unborn child, ensuing vaccinations and the resulting speech delays, tics, ADD, and autism.

Dr. Fritz Lorscheider, Ph.D. - Professor Emeritus, Medical Physiology & Biophysics - University of Calgary presented their video of a brain neuron exposed to 1/millionth of the amount of mercury used in an amalgam filling and the brain neuron's ultimate collapse.

Dr. Maths Berlin, Professor Emeritus, Environmental Medicine - University of Lund, Sweden, Former Chair, International Project of Chemical Safety, World Health Organization, (WHO). Dr. Berlin's presentation included nearly 100 research studies showing the dangers of dental mercury exposure. Dr. Berlin states that "Mercury is thus a multipotent cytotoxin that intervenes in the primary processes of the cell", "risk of impairment in the functions of the central nervous system," as well as: "impairment in kidney function," "impairment in the immune system," "impairment in foetal developments especially development of the nervous system," "impaired thyroid and muscular atrophy," "dermatitis," "tics," and "lowered sperm counts." Dr. Berlin went on to testify that they reviewed over 900 studies on mercury dental amalgam in the past five years. After eliminating 200 studies as weak, approximately 700 remaining studies were considered credible evidence that historical safety margins, that were formally thought to be valid, (with respect to mercury exposure from amalgam dental fillings), are now "nonexistent."

Ms Sandra Duffy, Esq. Attorney, has researched and "has recently become aware that hundreds of studies on the safety and effectiveness of mercury amalgam have been paid for by the National Institute of Dental and Craniofacial Research (NIDCR), a division of the National Institute of Health (NIH)." Ms. Duffy submitted 222 studies from 1994 - 2003. These studies were in a direct response to a 1993 request by the US Public Health Service, (USPHS). "To the best of our knowledge, only one of these studies has been published. "What the USPHS didn't apparently know in 1993 when it called for more studies on mercury amalgam was that the NIDCR had already funded 321 studies between 1972 - 1993." (With taxpayer's money). "Most, if not all, of these studies have not been published."

US Congressman Mike Michaud - Maine, testified to the difficulty in bringing protective legislation against such "roadblocks" by affluent lobbying interests such as the ADA. "Maine is the first-in-the-nation consumer brochure that tells people they better think twice before agreeing to have mercury fillings implanted in their children." Dr. Chester Yokoyama, DDS testified as to the difficulty in implementing a "fact sheet" in California where the entire dental board was fired for failure to provide this to the public.

Mr. Emmitt Carlton, Immediate Past President NAACP, in response to the Nov.14, 2002 hearing where the ADA represented the NAACP as "never having endorsed the Watson-Burton bill", corrected the record by stating "The NAACP adopted a resolution supporting the Watson-Burton bill only after a thorough and deliberative process. The national NAACP health staff, . reviewed the resolution, gave it a positive recommendation, .forwarded it to be debated in the NAACP Resolution Committee. The Committee endorsed the Resolution, submitted it to NAACP National Convention delegates for a convention vote in Houston. The resolution was adopted. The NAACP Board of Directors gave final approval to the resolution at its meeting two months later."

The ADA representative, Dr. Frederick C. Eichmiller, D.D.S., Director, American Dental Association Health Foundation, Paffenbarger Research Center, National Bureau of Standards and Technology states "the best and latest available scientific evidence indicates that it, (mercury dental amalgam), is safe." In addition he quoted the World Health Organization, (who was represented above), as saying, "No controlled studies have been published demonstrating systemic adverse effects from amalgam restorations."

Please support UnInformed Consent's quest to bring back the public's right to know the truth by purchasing videocassettes of UnInformed Consent's Episode I - Mercury, A Slow Death. To purchase call: (425) 487-2358 or visit UnInformed Consent at: www.uninformedconsent.com. UnInformed Consent will be there, bringing back the public's right to know the truth.

The Swedish Dental Material Commission has ended its work and recommends amalgam be banned:

The Dental Material Commission ­­ Care and Consideration

'The Dental Material Commission ­­ Care and Consideration' assigned Maths Berlin, in autumn 2002, to report on the past five years' research literature on amalgam and the health hazards, if any, of mercury. Maths Berlin is a Professor Emeritus with long experience of the effects of mercury on animals and humans. He chaired the WHO Task Group on Environmental Health Criteria for Inorganic Mercury (WHO Environmental Health Criteria 118, 1991) and a similar group with the function of drawing up health criteria for methylmercury. Professor Berlin compiled the environmental medicine risk analysis of mercury and amalgam issued by the Swedish Council for Planning and Coordination of Research (FRN) in 1998 (FRN, Report 1998:22). This risk analysis was based on literature published between 1993 and November 1997. The present risk analysis builds further on this material, and analyses literature published between November 1997 and November 2002.

Available on order from: The Dental Material Commission ­­ Care and Consideration Kv. Spektern, SE­103 33 Stockholm, Sweden or on the web site, www.dentalmaterial.gov.se

the root of the problem

01jun03

A visit to a holistic dentist's chair will cure more than just bad teeth, it could aid your wellbeing. By Emma O'Brien.

Homeopath Patricia Janson was stunned when one of her patients, who was recovering well from chronic fatigue syndrome, had a relapse. "He had improved so much and then, all of a sudden, he went downhill," says Janson. However, when Janson discovered her patient had a mercury filling fitted the week before his health began to deteriorate, she put two and two together. "I sent him along for a test and sure enough, his mercury toxicity levels were extremely high." The patient went to see a holistic dentist and had the amalgam filling removed. Immediately afterwards his health started to improve again. "I was so impressed I went and got all of mine taken out as well," said Janson. A trip to the dentist has always been a stressful, but basically unavoidable experience. However, rather than focusing just on the toothache, holistic dentistry focuses on your overall wellbeing as well. By making a connection between problems with your teeth and other ailments in your body, a visit to the holistic dentist's chair is a much more effective and positive experience. Not surprisingly, demand for holistic dentists has risen out of a growing desire among patients for a more whole-body approach to dental health. Dr David Howard is Patricia Janson's dentist. He runs a holistic dentist practice in St Leonards, on Sydney's north shore. "This [holistic approach] is the next step in dentistry. Instead of just being a person who feels for holes, we are thinking about how it affects the rest of the body," says Dr Howard. Painted in soothing pastel shades, Dr Howard's surgery has been assessed by a feng shui expert. Patients are encouraged to listen to CDs while having their work done. "These are just some of the small things we do to relax people and get them into a good frame of mind," says Dr Howard. A dentist for over 22 years, Dr Howard started to use holistic treatments in his surgery about 15 years ago. "I realised there were just so many treatments and materials being used in conventional dentistry that just didn't fit with some patients." Holistic dentistry is based on the premise that the body operates on five different levels. The physical level is the focus of most traditional western medicine. Two levels are devoted to the spiritual, while emotions, beliefs and thoughts are the domain of the mental level. Holistic dentistry focuses mainly on the electrical level, which deals chiefly with the nervous system and the electrical waves that transmit information and energy throughout the body. Electrical signals control most of the body's functions - when these are blocked or interrupted, patients can experience all manner of ailments, from headaches to muscle spasms.

get your teeth into it With 70 per cent of the body's electrical disturbances coming from the teeth, holistic dentists maintain that an aching tooth or a painful filling could be creating blockages to other parts of the body. "Many physical problems you have could have originally begun on another level," says Dr Howard. A holistic approach to the removal of a tooth would involve calming the patient thoroughly before starting the procedure. "The patient's state of mind is very important," says Dr Howard. Patients to his surgery receive homeopathy before the extraction to help the healing of the wound. While some holistic dentists use acupuncture to relieve pain, Dr Howard uses a local anaesthetic. "Acupuncture as an anaesthetic is only 70 per cent reliable," he says. Many of Dr Howard's patients come to him after receiving conventional dental treatments that have failed to heal or just don't feel right. "A poorly healed wisdom tooth, for example, can lead to many things, such as heart palpitations, body pain and angina," he says. Over half the patients visiting his surgery come to have their mercury fillings removed. The process requires much care and Dr Howard uses a strict set of holistic techniques. "When you remove amalgam fillings it lets off mercury vapour, which can lead to poisoning and headaches," says Dr Howard. Patients are put on a course of natural detoxification supplements for three months after the procedure. Patients who have had their amalgam fillings removed holistically have reported fewer aches, more energy and an improvement in their short-term memory, says Dr Howard. The Australian Dental Association states that there is no evidence to suggest mercury either leaks from fillings or causes any ailments when used in a filling, but they do recommend children and pregnant women not be fitted with mercury fillings. Dr Howard describes his patients as, predominantly, "free thinkers". "The people who come to me are somewhat distrustful of conventional approaches because of the lack of communication," he said. "I sit down with people for an hour and discuss their options with them. The physical-based, conventional mode of dentistry is one way of doing things, but it's not the only way," he explains. "I am just trying to offer a style of dentistry that is unlikely to damage people in the future." There's no longer any need for dentist-related hysteria

(amalgam is the largest source of inorganic and organic mercury exposure in most people)

In determining mercury concentrations in amalgam bearers' saliva, Pizzichini et al. (2001, 2002) found a significant correlation between mercury in saliva and the number of amalgam fillings in both men and women. Determination of total antioxidant activity (TAA) in saliva and plasma showed a significant inverse correlation between mercury concentration in plasma and TAA in both genders. In addition, antioxidant activity showed a significant negative correlation with mercury concentrations in women's saliva.

A large National Institute of Dental Health(NIDH) study of the U.S. military population with an average of 19.9 amalgam surfaces and range of 0 to 60 surfaces found the average urine level was 3.1 ug/L, with 93% being inorganic mercury. The average in those with amalgam was 4.5 times that of controls and more than the U.S. EPA maximum limit for mercury(MRL). The average level of those with over 49 surfaces was over 8 times that of controls. The same study found that the average blood level was 2.55 ug/L, with 79 % being organic mercury. The total mercury level had a significant correlation to the number of amalgam fillings, with fillings appearing to be responsible for over 75% of total mercury. From the study results it was found that each 10 amalgam surfaces increased urine mercury by approx. 1 ug/L. (amalgam was clearly the primary source of mercury exposure for the population)

The reference average level of mercury in feces(dry weight) for the thousands tested at Doctors Data Lab with amalgam fillings is .26 mg/kg, compared to the reference average level for those without amalgam fillings of .02 mg/kg. (13 times that of the population w/o amalgam). (thus the largest source of all mercury)

A large study was carried out at the Univ. Of Tubingen Health Clinic in which the level of mercury in saliva of 20,000 persons with amalgam fillings was measured(199). The level of mercury in unstimulated saliva was found to average 11.6 ug Hg/L, with the average after chewing being 3 times this level. Several were found to have mercury levels over 1100 ug/L, 1 % had unstimulated levels over 200 ug/L, and 10 % had unstimulated mercury saliva levels of over 100 ug/L.. The level of mercury in saliva has been found to be proportional to the number of amalgam fillings, and generally was higher for those with more fillings. The following table gives the average daily mercury exposure from saliva alone for those tested, based on the average levels found per number of fillings and using daily saliva volumes of 890 ml for unstimulated saliva flow and 80 ml for stimulated flow (estimated from measurements made in the study and comparisons to other studies). It also gives the 84th percentile mercury exposure from saliva for the 20,000 tested by number of fillings. Note that 16% of all of those tested with 4 amalgam fillings had daily exposure from their amalgam fillings of over 17 ug per day, and even more so for those with more than 4 fillings.

Table: Average daily mercury exposure in saliva by number of amalgam fillings

20 000 subjects were enrolled in a large scale field study to determine the concentration of total mercury in saliva. A statistical relationship was found between the mercury concentration in the pre chewing saliva and chewing saliva, and the number of amalgam fillings. The mean number of amalgam fillings was 9 and the median mercury concentration was 11.6 ¦g/l in the pre chewing saliva and 29.3 ¦g/l in the chewing saliva, which is considerably higher than reported in most previous publications. Extrapolation to the uptake of total mercury per week has shown that the provisional tolerable weekly intake (PTWI) value of the WHO is exceeded in at least 30% of the subjects.

1. Introduction

In the second half of the last century, the "first amalgam war" was fought in the USA for various reasons 1. The aim was to prevent charlatans also using this simple technique. The amalgams used at the time released very high quantities of mercury and "miracle cures" in patients with chronic diseases after removal of the amalgam fillings raised doubts about the material. A short "second amalgam war" was then started by the German chemist Alfred Stock 2, who drew attention to the fact that mercury is continuously released from fillings and may possibly be associated with a number of disease symptoms 3. The discussion of amalgam was renewed in the 80s when manifestations of the corrosion of amalgam were investigated 4 12. Ionic binding forms (Hg2+, Hg22+) and mercury complexes with natural substances were of prime interest. Attention has been paid primarily since the end of the 80s to the release of mercury vapour Hgo 13 22. In recent years, saliva in its property as solutizer and transport medium for mercury in its various binding forms has been increasingly taken into account 23 29, 42.

Gerhard 30, 31 has drawn attention to the relationship between infertility, polycystic ovaries, hormone disorders, loss of hair in women and heavy metal burden. Investigations at the Laboratory for Reproduction Toxicology at the T bingen Women's Hospital on the influence of heavy metals on humans reproduction have shown that female patients with amalgam fillings have a considerably higher mercury concentration in the follicular fluid than in those without amalgam fillings 32. To test the possible toxic actions of mercury on hormone producing cells, human granulosa cells were cultured. It was found that the hormone synthesis was significantly reduced already at a relatively low mercury concentration, while the cell vitality was almost unaffected 33, 34. For further insight into the relationships between amalgam fillings, mercury concentration in the saliva and fertility, a large scale field study using saliva analyses was carried out. In the present report, the results of mercury concentrations are presented. In a second publication correlations between symptoms of health and amalgam fillings will be shown.

2. Materials and methods

2.1 Group selection and sampling

People were asked to participate in the field study via an article in number 12/95 of the parenting magazine ELTERN as well as through a concerted publicity campaign in January 1996, which found widespread resonance in the German media. On sending a contribution to cover costs to the MOMO Stiftung, Radolfzell, participants were supplied with a test kit consisting of 2 tubes (each packed in a shock resistant transport tube) with precise instructions for filling and in addition a questionnaire for entering, amongst other things, body weight, number of amalgam fillings and symptoms of health.

The test kit consisted of two tubes. About 5 ml of pre chewing saliva was to be collected in the first tube. The instructions were that nothing should be eaten or drunk for 2 h before taking the sample. A line on the tube helped the estimation of 5 ml pre chewing saliva. In the second tube the total quantity of chewing saliva was collected that was obtained through chewing sugar free chewing gum for precisely 10 min. This was generally 15 20 ml. The test kit was sent to the Organic Chemistry Institute, where it was immediately recorded and analysed on receipt.

Up to the end of April 1996, somewhat more than 20000 subjects had submitted their samples. In the present report only the 17 351 individual results are analysed with respect to mercury for which complete data sets were available.

2.2 Reagents

The chemicals used were all of analytical quality from E. Merck, Darmstadt, FRG. Deionised water was produced with a Millipore device. Argon was used as the transporting gas and preparation of the solutions was based on the instructions of Guo et al. 35.

Standard solutions: All reference solutions were prepared in glass volumetric flasks. Before preparing the reference solutions, the flasks were rinsed 3 times with HNO3 (65%) and three times with deionised water. To prevent fluctuations in the reference solutions by vaporisation of the mercury, the reference solutions were not used for more than 2 days.

The stock solution contained mercury at a concentration of 1000 mg Hg/l. The reference solution contained 5000 ¦g Hg/l. It was prepared by diluting the stock solution with the addition of 1 ml of HNO3 (65%) to 100 ml. Calibration solutions with the following concentrations were prepared from the reference solution: 1.00 ¦g Hg/l, 5.00 ¦g Hg/l, 10.00 ¦g Hg/l, 20.00 ¦g Hg/l and 30.00 ¦g Hg/l. 2 ml of HNO3 (65%) to 500 ml of solution were added to the calibration solutions to assist stabilisation. For the blank solution, 1 ml of HNO3 (65%) was diluted to 250 ml with deionised water. As the solutions decompose with time, they were freshly prepared for each series of measurements.

2.3 Sample preparation

Before adding any reagents, the volume of chewing saliva was measured. Samples of pre chewing saliva and chewing saliva were subsequently mixed with 1 ml of HCl (32 36%). 500 ¦l KBr/KBrO3 solution was pipetted to aliquots of both types of saliva and then diluted with deionised water to final dilutions of 1:20 for pre chewing saliva samples and 1:10 for chewing samples.

If there were irregular measuring signals or the reference concentrations were outside the calibration range, samples in the autosampler tubes were again diluted 1:5.

2.4 Measurement Measurement of the Hg concentrations was carried out with a newly developed cold vapour flow injection mercury system with cold vapour atomic absorption from the PERKIN ELMER Bodenseewerk. Both the FIMS 100 (see diagram in Fig. 1) and the FIMS 400 were used.

05/14/2008 Philly First In The Nation To Require Mercury Disclosures By: JENNY DeHUFF , The Bulletin

Philadelphia - Freya Koss said she developed multiple sclerosis, lupus and other health problems from a silver dental filling containing mercury. She and several other consumer advocates and health professionals were at City Hall yesterday to tell their stories of cavity fillings gone wrong. The Pennsylvania Coalition for Mercury-Free Dentistry and Consumers for Dental Choice (CDC) stood in front of large signs warning of the dangers of silver amalgam fillings - most notable for their high levels of the neurotoxin mercury.

"The textbooks don't tell us this," said Charlie Brown, spokesman for the CDC. "It is absurd to think nothing is damaged when a neurotoxin is placed an inch from someone's brain."

"I quickly learned of the harrowing effects of mercury when an old filling was removed and a silver filling replaced it," said Ms. Koss, director of the Pennsylvania Coalition for Mercury-Free Dentistry. "Seven days later, I got sick."

Don Robbins operates a mercury-free dentist practice out of Exton. He called himself one of the few dentists committed to informing patients of the risk of silver amalgam fillings. Holding a jar of dental mercury filling, Mr. Robbins pointed out the skull and crossbones icon on the label, warning that the substance is hazardous to children and to handle the container with gloves and protective gear.

"It's deeply disturbing what's going on in our profession," Mr. Robbins said. "Less than 60 percent of dentists in the U.S. belong to the American Dental Association (ADA). Silver fillings are 50 percent mercury. If you have two, three or more silver fillings, you are above the Environmental Protection Agency's (EPA) limit for mercury intake." Earlier in the day, consumers protested statements made by the president of the Pennsylvania Dental Association. "No dentist places mercury in a patient's mouth," he was reported to have said. The alternatives to these types of fillings are typically white composite resin fillings, which are more commonly used today but don't last as long as silver fillings.